Recent public health data from Ottawa and Toronto schools reveal that over half of the students evaluated this year lacked current immunization records, highlighting an outdated system that hinders efforts to increase vaccination rates.
Toronto Public Health took action by sending out 60,000 letters during the summer to students in Grades 2 to 5 who had not submitted their records as required by the Immunization of School Pupils Act, which mandates vaccination against nine diseases for school attendance.
As of this month, approximately 54% (or 50,000) of students in Toronto remained non-compliant and faced potential suspension if their records weren’t updated promptly.
Similarly, Ottawa reported that as of October 12, more than 66% of students in Grades 2 and 12, totaling around 16,000 children, had outdated immunization records.
In Ontario, the responsibility lies with parents to provide immunization records to public health units, which send notifications to households with missing records or exemptions. Every year, local health units select student cohorts for compliance assessments.
Toronto Public Health highlighted that in certain grades, as few as 25% of students had current vaccination records, particularly impacting elementary school students.
Experts in public health emphasize that the high number of students receiving these notifications underscores the complexity of the multi-step process, involving the retrieval of yellow cards or documents from medical offices, leading to incomplete data for health officials.
“It’s not the most efficient process, and it’s not the ideal scenario,” stated Toronto’s Medical Officer of Health, Dr. Michelle Murti, in an October interview.
Decline in Vaccination Rates
Canada faces a critical juncture as vaccination rates decline amidst combating online misinformation. The country risks losing its measles-free status due to a prolonged outbreak infecting over 5,000 individuals in the past year.
Should Canada lose this status, it will need to demonstrate vaccination rates of 95% or higher and robust surveillance to regain elimination status, following assessments by the Pan American Health Organization later this year.
Dr. Murti proposed a streamlined process where health providers directly input vaccination records into a centralized provincial or national registry, a longstanding request from medical professionals.
Ontario’s Chief Medical Officer, Dr. Kieran Moore, echoed these sentiments, acknowledging the challenge of integrating data from diverse healthcare providers using different systems. The Ministry of Health is developing a digital tool for accessing vaccine records and personal health information, with no specified timeline available.
“We’ve been advocating for years on this issue,” emphasized Dr. Murti.
Dr. Milena Forte, both a family physician and a parent in Toronto, experienced the inefficiencies of the vaccine reporting system firsthand. She shared a recent incident where a mother received a notification from Toronto Public Health about missing vaccines for her children, despite being up to date according to Forte’s records.
Reflecting on her own encounter with a similar letter a few years back, Forte stressed the redundant tasks and resource allocation within the system, diverting attention from crucial health counseling.
Student Suspensions
Last year, Hamilton’s public health unit issued nearly 22,000 letters to parents in various grades about incomplete vaccination records, resulting in the suspension of around 6,400 students.
In the 2024-25 school year, Toronto Public Health reported suspending 6,090 students for at least one day, with over 4,400 students still suspended on the second day.
Joe Crampton, a parent in Hamilton, criticized the absence of a consolidated record system, contrasting the cumbersome manual entry process with modern digital access in other sectors.
Dr. Kumanan Wilson from Ottawa has long advocated for a vaccine registry, noting the resurgence of vaccine-preventable diseases like measles as a new urgency for addressing the existing challenges.